A 52-year-old woman with a history of hypertension presented to the emergency department with chest pain that started while sitting at work 2 hours previously. She described the pain as “someone sitting on her chest” and reported associated diaphoresis and shortness of breath.
She reported nonadherence to blood pressure medications. On physical examination, the heart rate was 99 beats per minute and blood pressure was 247/130 mm Hg. An electrocardiogram showed sinus rhythm with left ventricular hypertrophy (LVH) and inferior T-wave inversion. Laboratory values are shown in Table 1.
Paixao ARM, de Lemos JA. Acute Troponin Elevation and the Classification of Myocardial Infarction. JAMA. 2014;312(19):2032-2033. doi:10.1001/jama.2014.5554